Public Health & Service Learning: A Pathway to Internal Medicine

A four-hour drive should not be the difference between a routine fix and a life-altering outcome, but in many places it is. We sit down with Austin, a graduating medical student about to start internal medicine residency, to talk through the moments that made global health feel real: the patients you cannot “just transfer,” the family decisions shaped by cost and distance, and the quiet skills that matter when resources are limited. 

Austin walks us through his training path from the University of South Carolina, where he switched from biology to a public health degree and then earned an MPH. We unpack why public health is more than a nice add-on for premeds: it is a framework for health equity, social determinants of health, and understanding how systems push patients toward or away from care. If you have ever wondered whether you need a specific major to get into medicine, this conversation brings clarity without the hype. 

From there, we explore international service learning and experiential medical education through three settings: a first service learning trip to Nicaragua, a Guatemala project studying diabetes prevalence in underserved communities, and a month in Uganda combining clinical learning with quality improvement and capacity building. Austin shares how a teach the teacher mindset turns short rotations into sustainable impact, plus what “MacGyver medicine” looks like when creativity replaces equipment. 

If you are weighing an international rotation, we talk honestly about motivations, costs, and what it can and cannot do for your application. Subscribe for more global health and service learning stories, share this with a student who is on the fence, and leave a review if it helped you think differently. What experience has most shaped the kind of clinician you want to become?

I also want to thank our listeners for joining us as it is our goal to not only share with you our guest’s introduction to international healthcare, but also to share with you how that exposure to international healthcare has shaped their future path in healthcare. As true patient advocates, we should all aspire to be as well rounded as possible in order to meet the needs of our diverse patient populations. 

As a 50+ year nurse that has worked in quite a variety of clinical roles in our healthcare system, taught healthcare courses for the past 20 years at the university level, and has traveled extensively with my students on international service-learning trips, I can easily attest to the fact that healthcare focused students need, and greatly benefit from the opportunity to have hands-on experiential healthcare experiences in an international setting! I have seen the growth of students post travel as their self-confidence in their newly acquired skillsets, both clinical and cultural, facilitates their ability to take advantage of opportunities that previously may not have been available to them. By rendering care internationally, and stepping outside one's comfort zone, many more doors of opportunity will be opened.

Feel free to check out our website at www.islonline.org, follow us on Instagram @ islmedical, and reach out to me @ DrH@islonline.org

Transcript

Welcome And Purpose Of Show

Dr. H 0:11

Well hey there, I am Dr. Patrick Hickey, or Dr. H, as many of my students refer to me. I want to welcome you to another episode of the International Service Learning Experiential Medical Education podcast. During each episode, I will be interviewing healthcare-focused students and faculty from high school to university that have had an opportunity to participate in an international service learning trip. Additionally, I will be discussing the benefits and challenges to international service with healthcare professionals that have served abroad, as well as industry leaders in healthcare, education, study abroad, spirituality, and those living in the countries being served. Well,

Austin’s Training Path And Public Health

Dr. H 0:56

good morning. It's my pleasure to have Austin with us today. And just to let everybody know, I think we've known each other for well, I don't think. I know we've known each other for like I believe um probably six years, seven years maybe something like that.

Austin 1:10

I think we're actually hitting I think we're hitting ten. Oh my god. Yeah, four years of undergrad, four years of methods. Oh, by the way, two years in between, yeah.

Dr. H 1:19

Sorry how time flies. Yeah.

Austin 1:21

Oh, you're telling me.

Dr. H 1:23

Well, it's a pleasure to have Austin with us this morning. And and Austin started off as a student and has become a great friend. And it's such a pleasure as a faculty member to say that because I don't think very many faculty can can say they have that relationship. But that's uh a privilege I've been able to have with with Austin and a few other very special students. I know we're not supposed to have special students, but we have special students, and Austin's one of those. And a real pleasure to have him with us today. And Austin, I don't want to steal your thunder if you don't mind. Just tell us a little bit about yourself. I mean, you mentioned undergrad. Where did you go to school? What was your undergrad degree? And then you're just completing uh four years of med school. Update us on that.

Austin 2:02

Yeah, so thanks for introducing me. Happy, happy to be here in chat. Always a good time, you know, catching up and just uh talking about what's on my brain. Um, but I did four years at University of South Carolina, um, got my bachelor's of science in public health, loved it so much that I wanted to go on and get my master's in public health. So I did that shortly after met or shortly after undergraduate, and then you know, decided that like while I like the you know community aspect, population level, I really also like kind of the individual personal relationships that you get in the medical field. So that was one of the factors that kind of inspired me to pursue medical school. So I've been doing that for what seems like a very long but also very short past four years. So scheduled to graduate here in a couple weeks, and then I'll be starting my internal medicine residency uh come June.

Dr. H 2:55

Well, congratulations. You you you put it all into a into about a minute or so, but it's been stretched out over eight to ten years.

unknown 3:03

Yeah.

Picking A Major And Premed Myths

Dr. H 3:05

Now, when you start at the University of South Carolina, just because we have a lot of pre-med kids that are following us, was public health your your major coming in? And were you intent on being a doctor on on admission to the program?

Austin 3:22

Yeah, so um public health was not my major coming in, but I was intent on kind of pursuing the medical field. I came in kind of as like a biology major, which I think most undergrads do, just because for lack of better terms, I think that's what we're almost told to do. Did a couple of the biology classes, really liked it, but there was a lot of kind of extra classes that I didn't necessarily feel were like fueling what I wanted to learn, like plant biology and you know, ecology and all that stuff. Um I remember there was one day I went and met with my advisor and kind of just explained all these things to him. He said, Well, you should probably look into the School of Public Health because they offer, you know, the same kind of scientific foundation for career in healthy care, but they also go in a lot to like the social factors and kind of like the population level uh aspects that affect health. So marched myself over across campus to the School of Public Health, met with one of the advisors there, and then I think that day put my application into switch majors. Um and you know, no turning back since then. I feel like I caught the public health bug in a sense.

Dr. H 4:36

Well, it's great. I I know when I was at the University of South Carolina, I I kind of got a good or bad rap for twisting arms, so to speak, to switch students into public health because my master's and doctorate are public health. So I like you, I I consider public health population medicine. And I I think it really, really resonates with somebody going into medical school when you're treating people. And that's the beauty of the of the public health pathway. Well, thanks for clarifying that, because I know a lot of students, as you said, were told if we want to be a doc, we should be a biology major or a chemistry major, but know that you can be public health major and and a list of others, correct?

Austin 5:13

Yeah, I think just the main thing is regardless of what major you choose, because there are students, you know, fellow classmates in my class that were music majors or business majors or I mean architect majors. So it doesn't necessarily need to be like a scientific major in its core. You just have to make sure that you get those prerequisite classes under your belt. And typically go ahead. Sorry. No, go ahead. Yeah. And typically, you know, that's gonna be like your two classes of biology, your chemistry, your biochemistry, your physics. And you can largely incorporate those into a lot of majors. It just helps that, you know, like public health, the specifically the bachelor's of science, those are already requirements. So you had to learn those in addition to all like the community and population health classes.

Dr. H 6:05

So, major aside, going back to when you started in your undergrad, you wanted to be a doctor. Go back to when you knew or thought you wanted to

Family Experience That Sparked Medicine

Dr. H 6:15

be a doctor. Uh, because I I've never drilled down on that part. Where where did that come from?

Austin 6:21

Yeah, so um it actually came from some kind of like experiences of mine growing up. My my grandmother, when I was in about fifth grade, had transverse myelitis, which unfortunately, you know, parap paralyzed her, caused her to become paraclegic. And then as a result, she couldn't live on her own anymore. So she came in and moved in with my brother, sister, and mother and I. And I kind of saw healthcare from like a different lens. Like I feel like a lot of people I've talked to, their experience for healthcare is mostly from like a provider aspect, from like shadowing or working in an office. But I kind of from an early age saw it from like a patient family support system side. You know, I wasn't the one with the disease and going through that. But, you know, at the end of the day, whenever we would take my grandma to her appointments and we'd come back to the house, like she would still have the disease because unfortunately it is a non-curable terminal disease. So I got to see kind of the behind the scenes of that, you know, all the good doctor's visits, the bad doctors' visits. And then ultimately, you know, she passed away when I was in college. So I kind of got to see like the end of life transition in healthcare too. So I think that just laid like a really strong foundation and admiration for the healthcare field for me, which, you know, ultimately inspired me to pursue a field in healthcare in general. And then specifically when I think about you know becoming a physician, it's like the leadership, leadership aspect of it. The you know, working with a team, I really like team-based medicine. So when I was looking at like all the different roles in the healthcare field, that was the one that just kind of resonated the most with me.

Dr. H 8:05

Well, thanks for sharing, Austin. I don't know if we if you'd shared that story with me before or not, but you know, in reality, when I when I've drilled down with a lot of students over the years, it it does seem that a lot of them do have a family situation or issue or medical crisis where they were in involved in something, whether it was themselves or a family member. And because of what you just shared, they saw the care that was provided and they saw themselves in that role. You know, and and then whether it was good or bad, you know, if it was good, it was a good role model. If it was bad, they they shared with me that if I'm in that role, I could do a better job than what they did. Or or they had or they had a really positive interaction and they were they loved it and they could see themselves doing the same thing. So uh your grandmother would be proud of you doing what you're doing because of that interaction, and and what what a great story. Again, thanks for sharing. So back to back to the purpose of our podcast, which is the service learning.

Service Learning Across Nicaragua, Guatemala, and Uganda

Dr. H 9:05

You went on a service learning trip. What what prompted you to go on that trip? And if you could share where you went and and what that was all about?

Austin 9:14

Yeah, so um the I I've been on a couple service learning trips since that first one. It's another testament of just how you know awesome it was. But uh my first trip I took was sophomore year of undergraduate. It was a service learning trip to Nicaragua, had a good mix of you know, in the clinic, kind of rural healthcare exposure, but also, you know, in the hospital, working with like organized healthcare delivery, which I knew was kind of an aspect that I really liked from like my you know public health classes and just kind of a better understanding of the healthcare system as a whole. We learned a lot about how it functioned in the United States, but not so much how it functioned in like other countries. So that was a really exciting aspect for me, as well as just like the direct patient care opportunities, and more so, you know, maybe not providing the care myself, but just watching how other healthcare providers kind of navigate complex situations. Because one of the things that you know I've kind of learned is that while the details might be different, I think a lot of like the challenges are universal, whether it's in like a large academic center in the United States or it's like a small rural clinic, you know, in the middle of the mountains, diseases or diseases. You still have to break bad news, you still have to navigate things with patients. Um, you have to navigate, you know, barriers to healthcare delivery, whether that's you know, social determinant of health or like an actual like physical barrier in some of the cases. So it was really kind of inspiring to watch how different, you know, physicians and nurses and healthcare professionals from different backgrounds kind of navigated those. So that was kind of the main driver for me wanting to, you know, go abroad and do a service learning trip, you know, in an area that I wasn't used to with like a population and community that I wasn't used to.

Dr. H 11:08

What now you indicated that you've done trips since then. So your initial trip was sophomore year to Nicaragua. What have you done since then?

Austin 11:16

Yeah, so first trip was sophomore year to Nicaragua, and then during my master's, I went down to Guatemala for like another kind of service trip and also slashed like a research trip. And then most recently, I got to work in a hospital in Uganda for a month. Um kind of doing like a tandem rotation service learning and a research project.

Dr. H 11:41

So your research project in Guatemala was looking at diabetes, is that correct?

Austin 11:46

Yeah, it was looking at kind of like a it was like a cross-sectional study of like the prevalence of diabetes in some of these like communities along the lake Attislan, mostly like indigenous mind communities that aren't necessarily counted in a lot of like the government census. And it was looking at like a the prevalence of diabetes and pre-diabetes, but also the prevalence of some risk factors that the literature has shown to kind of increase the chance and just to see if there's you know some kind of like correlation or just trends that we could see from this like one one point in time.

Dr. H 12:24

And then Uganda, that was part of your med school rotation, is that correct?

Austin 12:29

Yeah, so the way that my school's curriculum was set up is that after we took our first board exam, our step one exam, we had like a two-month period of just dedicated research time. And I was able to get in contact with a physician who did a lot of work at a hospital over in Asindi, which is this like smaller kind of town in Uganda. So I was able to go over there. It was like a quality improvement capacity building project. So it was like right up my alley in terms of seeing, you know, what capabilities the hospital had, what areas to improve on, you know, mirroring that hospital's capabilities with like a government public hospital down the road. And then on top of that research product, it was a lot of like clinicals on the units, you know, observing surgery, doing daily rounds, typically like what your like third and fourth year medical students would do.

Dr. H 13:24

So did you feel at that stage in your medical career you were able to mentor or educate some of the locals?

Austin 13:33

I

Teaching The Teacher In Uganda

Austin 13:34

I use the term educate lightly. I I think I long story short, yes, I do. I think one of the one of the things that we really drilled down was like the teach the teacher model because we were only there for you know a month, but a lot of these practitioners, this was where they lived. So instead of us, you know, coming in and kind of doing our work and then leaving, we really wanted to focus on that sustainability aspect of it. So one of the things that I mainly focused on was like a very basic EKG kind of rate and rhythm determination. So I was able to sit down with a bunch of like the clinical officers, the nurses, and we just like went through EKG strips after EKG strips, just seeing like, okay, you know, what's the R to R interval? What's their heart rate? Is there a P wave? Are they in normal sinus? Which I thought was really, really rewarding because as a med student, I think it's very easy to uh to forget that how much you know just because there's so much that you don't know. So it was nice to kind of like sit down with other healthcare professionals and be like I was able to share some tips and tricks that I learned, and they were able to share some you know new mods on how they remembered things. Um so it was really like a very fun collaborative effort.

Dr. H 14:51

Well, there's great collegiality in healthcare as as you'll see as you continue on your pathway, and it's nice that you guys are able to work together. Now you've been three different places Nicaragua, Guatemala, and Uganda. No doubt you've you've learned a lot. You talk globally about your experiences and all those. Is there anything that jumps out uh from I mean any of the trips? I mean, uh I know the the Nicaragua one was was quite some time ago, as was Guatemala, and Uganda's more recent, but was there any any patient or or situation or or condition that that resonates with you uh right now?

Hard Cases And The Reality Of Access

Austin 15:26

Yeah, you know, I when I think about kind of the various patients I've had, you know, one of the the ones that stick out to me aren't necessarily like the ones that we were able to make a big impact. It's the ones that we not we necessarily weren't able to make a big impact. Specifically when we were in Uganda, so the way that their kind of healthcare system works is a lot of the specialist doctors are in the capital of Kampala. So like all of the interventional like cardiologists, the electrophysiologists, you know, like interventional neuroswees, they're all in the capital, whereas kind of throughout the rest of the country, it's more so like like they have hospitals with good capabilities, but they don't have all like the cutting edge technology. So where we were at, it was a four-hour drive to go from Mascendi to Kampala. And we had a young girl come in who was complaining of you know some chest pain, some heart palpitations, and just overall not feeling well. So able to hook her up to an EKG. But we actually saw that she had heart block, which, you know, in the States, fairly not gonna say run in the mill, but you know, not uncommon to see be a referral to electrophisiology. They'd get a pacemaker and kind of be on their way. But in this specific instance, you know, it was a girl from a smaller family, not a lot of kind of wealth. So a four-hour trip to the Capitol just to be seen, you know, not even to get the care, just to be seen was a little bit out of the round of like the possibilities for what this family could afford. So I think that was very eye-opening and also kind of like a step back moment, thinking about what's available in the United States and what we're so used to versus you know, what's not available, you know, over abroad. And then another similar story. We had a child who came in who had a very bad pneumonia. We were able to get a chest x-ray, you know, knew exactly what was happening, but the child deteriorated kind of past the point of what our facility was capable of handling. And the only dedicated children's hospital is also in the Capitol, which was four hours away. So we like counseled the family, you know, told them we had basically reached the maximum of the interventions we could do here. Like our best recommendation is to go to the Capitol and kind of seek like a higher level of care. Um you know, ultimately the family decided that that was not really in the realm of possibilities for them financially or feasible-wise. So they kind of opted for like a comfort care for that child instead, which was, you know, for me, kind of challenging and hard to comprehend because you know, in the United States, I feel like a lot of the culture is you do what you can, you go the whole nine yards. So it was challenging knowing that, you know, had this child been at the children's hospital in Charleston, you know, he would have been a very stereotypical case, would have gotten the carrying it, probably would have gotten discharged in a week. But just given the situation and circumstances that that child was in, that wasn't necessarily possible. So I think it's just that, you know, that matter of perspective is something that you don't necessarily gain until you were put in an environment like that.

Dr. H 19:03

Well, it's it's actually, excuse me,

Lessons For US Rural Care

Dr. H 19:05

it's actually great that you got to see that during your your med school rotations because those are the things you're going to be exposed to in in your practice. It seems that access to health care or access to healthcare resources are global. So it's not just in a developing country. It's here in the United States. Even though you say that typical child that you saw, if treated in Charleston, South Carolina, would have had a better disposition. There's still going to be a lot of people in rural areas here in the United States that are three or four hours away from a main hospital who are still going to have unfortunate outcomes.

Austin 19:42

Yeah, for sure. And I also think that like one of another like lesson that I've kind of learned is that like challenges and like you said, a rural healthcare setting in the states can be very similar to like a rural healthcare setting abroad. So it's it's very enlightening to see, you know, how some of these healthcare practitioners are able to manage those challenges. And I've actually learned, you know, quite a lot from them abroad that I like planning to take back with me whenever I do, you know, have a patient who, let's say, you know, lives two hours away from the hospital and doesn't have a car, or a patient who might not have the best food security kind of ways to navigate that, or even you know, like medication security. You know, over internationally I've seen that like a lot of the issues with medications are access, whereas over here I've seen a lot of issues are like financial. So ways to kind of like tailor drug regimens to where they're still effective but more you know feasible for a patient to adhere to.

Dr. H 20:43

Well, that's great. Thank you for sharing that, that you learned a lot from them. I know when I taught my course many, many, many years ago that I would share with my students that we're going to learn a lot from the people that we encounter. And there was a lot of skepticism about how can we learn anything from them? You know, we we we're we're we're much more modern, we've got a lot more resources, but sometimes we found that when you have a lack of resources, you have to be more ingenious in how you get around a certain problem. Like you said, food resources or medications, you have to develop other ways to to help the patient to to have a positive outcome.

Austin 21:20

Yeah. And I it's also kind of one of the cool things is like, you know, at least from what I've seen and my experience with like big academic health care, there is a device or a you know, there is something for everything. Whereas I've seen, you know, abroad, like kind of like MacGyver medicine, where it's like, you know, you you have an NG tube, which is in the States would only be used for one specific thing, but I've seen it used for like IV tubing, or I've seen it used for, you know, like like kind of off label applications, but like were still effective. Not necessarily, don't know if that's as translatable. To the United States, given that we have access to all these different kinds of modalities. But from like my nerd perspective, it was kind of cool to see that that happened.

Dr. H 22:09

Well, it's neat you bring that up because I attended an honors college thesis defense just uh last week, one of my students, and she spoke a lot about the over-medicalization of our system and the cascade of events that can happen when we when we do too much intervention and we treat things that maybe we shouldn't be treating. And from what you're saying, in in developing countries, looks like they have to be able to do more with less.

Austin 22:38

Yeah. Yeah, I think when I was on my IC rotation, one of the attendings, and I'm gonna butcher the stat, but he was basically telling us that like almost 80% or around that number of all healthcare spending that occurs in the last like six months of a patient's life. Which I thought was like, you know, kind of just a crazy static face value, thinking about like, well, if we maybe weren't so focused on, you know, prolonging life, more so just prolonging quality of life, if we could maybe, you know, see if there'd be any changes to that.

Dr. H 23:14

Right. No, I I hear you. And I I've heard some similar numbers. I I don't know if it was 80%, but something

Next Steps Internal Medicine And Global Health

Dr. H 23:20

very, very high that kind of shocked me. Yeah. So it sounds like you've learned quite a lot from the uh three international rotations, and some of that stuff you're gonna help you. How will that help you moving forward with your in fact? Tell us if you don't mind, what what are your next steps? You're you're you're graduating in in a couple of weeks. Uh I'm excited to be attending your graduation. And just to share with people, I I had the best news ever when Austin asked if I would gown him or hood him at his graduation ceremony. So that's a privilege that I've never had before. So I'm looking forward to that. But what what is your goal? Tell us your path and and that name of the kind of doctor that you're going to be that I referred to you the other day.

Austin 24:05

Yeah, I I think the term you're looking for is a nerd doctor. I think that's what you called me the other day. But I uh I'm gonna do internal medicine residency. I'll be moving up to Virginia to kind of complete my training up in that part of the state or the country. But you know, long-term goal is still kind of on the table. I've toyed with the idea of like a fellowship either in like hospital medicine or critical care or cardiology. But you know, at the basis, what I want to learn the most from my training is how to be a good internist, how to you know look at a bunch of different data points and you know make sense of it, how to you know manage a patient and almost all their body systems and you know, almost all disease process, not needing like a specialist level of care. And then one of the cool things about my program is they have a fairly um like a fairly comprehensive built-in global health pathway, which I'm gonna you know try and apply to and see if I can do some more international rotations with that. But going back to the question of like what does my you know international experience kind of thing and how I use it going forward, I really think it's just kind of a matter of perspective. Like there is a lot of patients in the hospital that you know I've encountered, that you will encounter, that are just not the same as me in terms of like the medical condition, in terms of background, in terms of culture, and it's just being able to be at a level with someone who you're not necessarily similar to, I think is invaluable in healthcare. You know, whether that's like communicating an issue in a culturally you know sensitive manner, or it's you know, building like Western medical technology with like maybe some more traditional medical practices and trying to find like a common ground. Because at the end of the day, you know, the way that I want to practice is a lot of like sheer decision making. Um, I I didn't go into medicine to necessarily tell people how to live, but I want to be there to help them in any way that I can. So that's you know, laying out all the options that we can do from a medical standpoint and then kind of you know helping them make that decision for what's best for them is kind of my ultimate goal. And I think just being more like conscious of the different backgrounds, the different challenges that different people face will help me understand better when you know a patient maybe doesn't decide to do something that I necessarily think is, you know, the best medical. But again, I'm not the patient.

Dr. H 26:43

Well, knowing you as I know you, and I'm privileged to to be able to say that. I I know that your future patients and families are gonna be very blessed to have you as their caregiver. You you've got a good service heart, uh, proven by your your three service trips. You share with us that you've learned a lot from those experiences that you're gonna carry forward, probably gonna be a lot more sensitive to your international population, which I'm sure you're gonna be encountering no matter where you go. And speaking of that, how's your medical Spanish?

Austin 27:15

It it it can be improved on, I will say. I that is something that I do want to improve on. I I was recently in Peru with some friends, and I'll say that my like conversational Spanish has improved a lot, but don't really find a lot of opportunities to practice medical Spanish if you're not in like a medical setting. But that like I can say I can always get better at a lot. That is that is one thing that I would definitely need to get better at.

Should You Do A Service Trip

Dr. H 27:43

So uh Austin, for students that are considering a similar trip, probably on the fence, you know, is this you know, have an opportunity to go on an international rotation, whether it be during undergrad or during grad school, you know, maybe a little intimidated by the language or the culture, maybe the costs a little bit too much. What is the value? I mean, you've done it three times now. What would you share with students that are trying to consider, you know, will this help me? Will it look good in my resume? You know, am I doing it for all the right reasons? What would you share?

Austin 28:15

Yeah, I mean, I think I think you kind of hit the head in the term of am I doing it for you, quote, right reasons? And you know, the the right reasons are gonna be different for everyone. Like I remember, you know, my my first trip and my first motivation was mostly just to learn more about how like a different system runs and to see how different, you know, how your practitioners kind of navigate that area. Remember, there were some students on our trip who their right reason was this was their first political experience ever, like not just international, but they tried you know to have political experiences in the States and it didn't work out, and this was just you know a perfect opportunity for them. I think it really you know kind of depends what their individual goals are. In terms of like doing a trip like this just because it'll look good on the application, because like you mentioned, you know, it is costly, it is a time commitment, it does force you to go out of your comfort zone. And I would say I I think all my trips are valuable, and they I think they've definitely been talking points in all of my interviews going forward, but to be fully candiding, you know, in terms of will they help your application. I think if if you're not really in it for the right reasons, then there are other areas that you can maybe focus on to get kind of like a better thing for your book in a sense of your application. But I think for anyone, if you have any interest in you know, going out of your comfort zone, seeing how another system operates, interacting with you know, patients and healthier practitioners and family members kind of at a level beyond what you normally would, I would accept or I would uh recommend it for me, honestly.

Dr. H 30:02

Well, I appreciate that validation. As you know, I've done it for over 20 years, and I I can see, I mean, I can speak for hours about the the value of it, but you really hit the nail on the head also, and and I think doing it for the right reason is so integral to the experience. And and yeah, you know, the more well-rounded you can become as a healthcare provider, the more positive the patient experience is going to be. You don't necessarily have to speak the language of the patient, you don't necessarily have to have visited their country, but if you've been to a developing country, you're more sensitive to the challenges that they experience. You you don't know them personally, but you know that that you know they or their people, their family or friends have gone through challenges that we can't even imagine. I mean, I I can't recall on your Nicaragua trip, but but on many of my trips to Nicaragua, some of the housing conditions were absolutely deplorable compared to our standards. So so knowing that, I mean, we put a lot of faith in our water system, we put a lot of faith in electricity, we put a lot of faith in so many things that we take for granted until you step outside your comfort zone, as you've indicated. And it's only then that you see the challenges. And and you've been very blessed with three different opportunities to see three different healthcare systems. The beauty of that is once you learn a system, then you can work the system to advocate for your patients. Because all of us to a T want positive patient outcomes. And sometimes the bureaucracy of a healthcare system is very challenging. I don't know if you've experienced that yet in your short term in medical school, but you're stepping into a healthcare system that can be very challenging. But once you learn the system, you can better work the system again to advocate for your patients. And that's what it's all about. We all want positive patient outcomes and not just the patient. When I speak of the patient, I speak globally patient and their family, because you don't you're not treating just the patient. You're treating the family also, because if you're changing diet on a patient, it's probably best if the family changed the diet to support you know, that diet change with the family member that needs to change their diet, or if a family member of the patient needs to uh increase their exercise or activity level, it's probably good if the family also supports them and increase their their education and their activity level. So a lot of education is helping our patients. Well, Austin, it's been great chatting with you. I really appreciate you sharing everything you've done. What what a great opportunity you've had to travel extensively as you had. And I I know for certain that that those activities that you've done, those experiences that you've had, the teaching you've done at this point is only going to help your future patients to be in a much better place. So so we we really appreciate that. Any last things you want to share with uh with our listeners before we sign off?

Austin 32:52

Um thank you for having me. Like I said, always a great time to chat. Always love talking about you know my experiences and kind of advocating for others to maybe go out of their comfort zone and do something similar. Really? Nothing else to add other than you know, if I think if you're on the fence and it's something that you truly want to do, then I think it's definitely worth spending the time to kind of invest in see how it's feasible. Because I think ultimately it is an investment in yourself.

Pay It Forward And Final Takeaways

Dr. H 33:24

Well, I know I know the the investment. Speaking of investment, I know the investment that I've been able to put into working with students like yourself is that you know, I always share with all of you to a T, you know, pay it forward. I always share with all of you to a T that if somewhere, hopefully in the future, as you're working in a hospital setting and someone comes up and says, you know, Dr. Austin, we've got a high school kid or a college kid that would like to shadow you to uh today, is that is that possible? And my hope is that you'll say, but of course.

Austin 33:54

Yeah, yeah, but of course. Yeah, I know. I mean, I that's ultimately that's the plan. I remember I had an attending tell me one time that like healthcare is not an individual sport by all sense of the means, it's a team sport. And the easiest way to to kind of make your job easier and closer is to just help the next generation or to help the people that are assumed to be your co-workers. So, yeah, I mean yeah, anyone that wants to become shattered, spend a day when I'm in a position to be able to facilitate that, well, definitely.

Dr. H 34:29

Well, and that that's what excites me about working with yourself and and others that that we're creating a generation like yourself that want to do that. Not that the present generation doesn't want to do it, but it is challenging, as you know, in our existing healthcare system to shadow doctors with HIPAA regulations, with the busy pace, but with intentionality. And I think because you step outside your comfort zone and do your international rotations, I think it sensitizes you a little bit more to the challenges of our healthcare system. You've seen three different healthcare systems. You already know some of the imperfections in our own healthcare system. The fact that you are very willing to allow students to shadow you in the future speaks to the opportunities that that you've had that you maybe didn't have actually as you grew up. From what I see with these international rotations, a lot of students will do them because they they can't get that experience in the United States. You know, as you said earlier, sometimes it may be their first clinical rotation because they've never been able to do it. And and again, that's one of our challenges. How are we supposed to create that next generation of sensitive healthcare providers like yourself if we don't allow them to fill the shoes of that mentor or shadow a mentor or walk in their shoes, so to speak? So, so again, learning those lessons as you have, you're gonna be one of those of the next generation that are gonna be able to uh hopefully bring more people into healthcare, which we desperately need. So, thank you, thank you, thank you for everything you've done and everything you will continue to do. And I look forward to following the uh future practices of the nerd doctor as you uh progress through your pro your profession. And as I said earlier, um I'm I'm adamant and I'm certain that all of your future patients and families will be very blessed to have you as their healthcare provider.

Austin 36:23

Like I said, I appreciate it. I appreciate the kind words. And I I don't say this lightly, could not have been where I'm at plus where I'm going without excellent mentors like yourself. Definitely kind of instilled the sense of pay it forward in me. So I I commend you for kind of being the role model in that aspect.

Dr. H 36:42

Well, I appreciate that. I see a lot of me and you, so we'll leave it at that. Well, thank you again for your time.

Austin 36:49

Awesome. Sounds good. Thank you so much, Dr. AB.

Dr. H 36:54

I want to sincerely thank our guest, Austin, for his willingness to join us on the International Service Learning Experiential Medical Education podcast. But most importantly, I want to thank Austin for the passion that he has shared with us today. Austin is a great ambassador for international service learning, and I'm very hopeful that by sharing details from his multiple service learning trips, he will inspire students to step out of their comfort zones and to go forward as far as pursuing a similar opportunity.